Jason Fodeman: VA, Obamacare regulations hurt doctor-patient relationships

2014-06-06T00:00:00Z 2014-06-06T13:55:36Z Jason Fodeman: VA, Obamacare regulations hurt doctor-patient relationshipsBy Jason Fodeman Special to the Arizona Daily Star Arizona Daily Star

The Veterans Affairs scandal is a case study in health care gone wrong. We must grieve for those veterans who lost their lives — but we must also demand a diagnosis so this doesn’t happen again. During my medical education and training and now as a practicing doctor in Tucson, I’ve spent years identifying the problem.

I reached one conclusion: Patients suffer when bureaucrats meddle in their health care.

This lesson doesn’t just apply to the Department of Veterans Affairs — it applies to Obamacare. Both systems, in different ways, constrain health-care providers with burdensome regulation and red tape. Such restrictions only disrupt the doctor-patient relationship. The patient suffers the most.

I personally witnessed this during my residency at a VA hospital in Los Angeles. I often saw bureaucracy and rigidity impede my ability — and the ability of other physicians — to provide patients with timely medical care, no matter how much they needed it.

The problems stem from the VA’s very design. Unlike a private business, the VA serves a political purpose rather than veterans. When businesses fail their customers, they fail; when bureaucracies do it, they get more funding. This cycle repeats itself. If failure begets more funding, why should you stop failing?

Now the VA is flush with taxpayer money. According to the Wall Street Journal, its funding grew 106 percent between 2003 and 2013, even though it only saw 30 percent more patients. More money will never cure this — only reform will. The problems are simply too systemic to be fixed with a bigger paycheck.

Similar problems beset Obamacare. Unlike the government-run VA, the president’s health-care law meddles in the private sector by imposing regulations on health insurance companies, hospitals and doctors in private practice.

This leads to three unintended consequences for consumers like you and me. First, it artificially limits our choices — think of the insurance cancellations that hit thousands of Arizonans last fall. By mandating what insurance plans can and can’t cover, how much they can cost for different people and more, Obamacare creates one-size-fits-all plans that may not meet an individual’s actual health needs. Want to see your old doctor? No longer in the network. Want a specific treatment? The plan doesn’t cover it.

Obamacare also dramatically increases costs. Arizonans know this all too well. Since the law went into effect, Forbes estimates that individual insurance premiums in Arizona have spiked by 51 percent. They are guaranteed to rise again next year.

Blame bureaucracy. Obamacare has already added 11,000 pages of new government regulation, as tallied by USA Today. More is added every day, including a 430-page dump late last month. Each new regulation forces hospitals and doctors to hire more administrators and lawyers who deal with the red tape. This diverts more time, energy and resources away from patients, while increasing costs across the board.

Regulation also restricts what services and treatments doctors can perform. This is perhaps the biggest threat to patient well-being. By our oath, every doctor promises to pursue their patients’ unique health needs. This becomes harder to fulfill when the government sits in the treatment room and tells us what we can and can’t do. With each new regulation, doctors become more like assembly-line workers — legally prohibited from addressing patients’ individual health needs.

This wasn’t Obamacare’s intent. Nor did the VA’s architects foresee the current scandal. But both systems ultimately harm their intended recipients by putting barrier after barrier between doctors and patients. Good intentions — and more red tape — can’t break down bureaucracy’s inherent roadblocks and veterans shouldn’t have to die for us to learn this lesson.

Jason Fodeman is a board-certified internal medicine doctor practicing in Tucson. Contact him at fodymd@gmail.com

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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